Stress & Anxiety Before Surgery
It’s completely normal to feel nervous or anxious before an operation. While some anxiety can help some patients prepare psychologically and have realistic expectations post-surgery, a little too much can have a negative impact on the impending surgery. There is no cure for anxiety but there are ways to cope, and your care team can offer you support as well.
What effects can anxiety have?
Anxiety can have both psychological and physical effects. Psychological effects present in the form of aggression, apprehension and tension while the following can be unpleasant physical signs of anxiety:
A pounding or irregular heartbeat
Nausea or a nervous stomach including diarrhoea
Shortness of breath
Sleep problems
Patients who are highly anxious pre-surgery are likely to experience higher levels of post operative pain resulting in the need for stronger analgesia and prolonged hospital stay.
This group of patients can also have a hard time understanding and remembering important things they are told about the operation, such as advice about how to prepare for it or about recovering afterwards.
People who smoke generally feel more nervous, resulting in a greater need for a cigarette right before surgery if they stopped too close to the surgery date. As smoking increases the risks of complications after surgery, it is recommended that nicotine replacement therapy is started at least 1 or 2 months before surgery to curb this desire.
What can help my anxiety?
Occasionally the anaesthetist may prescribe a pre-medication to calm you down especially if your heart rate or blood pressure becomes very high due to anxiety.
Sedatives may be given to help you relax and make you sleepy at the same time.
It is important to tell your doctor if you have already taken some sedatives before you came into hospital.
You may find the following tips useful to help you cope with pre-surgery anxiety:
Talking with family or friends about what makes you nervous.
Educate yourself from trusted sources by reading information given to you about your procedure and asking questions to address any concerns you may have.
Keeping busy by reading, exercising, or doing relaxation techniques like slow and deep breathing.
Listening to music they enjoy before surgery to relax.
Plan in advance, such as arranging transport to hospital and aim to arrive early.
Some patients benefit form a ward visit pre surgery date to familiarise with the environment,
Your care team is there to support you in your surgery and your emotional preparation for it. Most hospitals provide contact with counsellors, social workers, or volunteers who can offer support and help to relieve anxiety. Talk with your care team openly about your level of nervousness and ask questions if they will help you feel more informed and safe.
References
National Center for Biotechnology Information, 2014, What Can Help Relieve Anxiety before Surgery? U.S. National Library of Medicine, Accessed 8 September 2022 - https://www.ncbi.nlm.nih.gov/books/NBK279557/
Wetsch, W.A, et al (2009) Preoperative stress and anxiety in day-care patients and inpatients undergoing fast-track surgery. British Journal of Anaesthesia. 103 (2): 199–205
Mitchell M (2012) Anxiety management in minimal stay surgery: Nursing times 108(48) pg. 15-16
NHS (2022) NHS talking therapies. Accessed 28 August 2022